CS Lymph Nodes

Notes

**Note 1**: Code only regional nodes and nodes, NOS, in this field. Distant nodes are coded in CS Mets at DX. **Note 2**: If at mediastinoscopy/x-ray, the description is "mass", "adenopathy", or "enlargement" of any of the lymph nodes named as regional in codes 100 and 200, assume that at least regional lymph nodes are involved. If there is any mention of bilateral or contralateral mass, adenopathy or lymph node involvement , use code 600. **Note 3**: The words "no evidence of spread" or "remaining examination negative" are sufficient information to consider regional lymph nodes negative in the absence of any statement about nodes. **Note 4**: Vocal cord paralysis (resulting from involvement of the recurrent branch of the vagus nerve), superior vena cava (SVC) obstruction, or compression of the trachea or the esophagus, may be related to direct extension of the primary tumor or to lymph node involvement. The treatment options and prognosis associated with these manifestations of disease extent fall within the T4-Stage IIIB category; therefore, generally use CS Extension code 700 for these manifestations and not CS Lymph Nodes . However, if the primary tumor is peripheral and clearly unrelated to vocal cord paralysis, SVC obstruction, or compression of the trachea or the esophagus, code these manifestations as mediastinal lymph node involvement (code 200) in CS Lymph Nodes, unless there is a statement of involvement by direct extension from the primary tumor.
Code Description AJCC 7 N TNM 6 N Summary Stage 1977 N Summary Stage 2000 N
000 No regional lymph node involvement N0 N0 NONE NONE
100 Regional lymph nodes, ipsilateral:
Bronchial
Hilar (bronchopulmonary) (proximal lobar) (pulmonary root)
Intrapulmonary nodes, including involvement by
direct extension:
Interlobar
Lobar
Segmental
Subsegmental
Peri/parabronchial

Stated as N1 with no other information on regional lymph nodes
N1 N1 RN RN
200 Regional lymph nodes, ipsilateral:
Aortic (above diaphragm), NOS:
Peri/para-aortic, NOS:
Ascending aorta (phrenic)
Subaortic (aortico-pulmonary window)
Carinal (tracheobronchial) (tracheal bifurcation)
Mediastinal, NOS:
Anterior
Posterior (tracheoesophageal)
Pericardial
Peri/paraesophageal
Peri/paratracheal, NOS:
Azygos (lower peritracheal)
Pre- and retrotracheal, NOS:
Precarinal
Pulmonary ligament
Subcarinal

Stated as N2 with no other information on regional lymph nodes
N2 N2 RN RN
500 Regional lymph node(s), NOS N1 N1 RN RN
600 Contralateral/bilateral hilar (bronchopulmonary) (proximal lobar) (pulmonary root)
Contralateral/bilateral mediastinal
Scalene (inferior deep cervical), ipsilateral or contralateral
Supraclavicular (transverse cervical), ipsilateral or contralateral

Stated as N3 with no other information on regional lymph nodes
N3 N3 D D
800 Lymph nodes, NOS N1 N1 RN RN
999 Unknown; regional lymph nodes not stated
Regional lymph node(s) cannot be assessed
Not documented in patient record
NX NX U U